Routine screening for adverse childhood experiences (ACEs) still doesn't make sense

Area of Science:

• Public Health
• Child Development
• Health Services Research

Background:

• Universal screening is often proposed for prevalent health and social issues.
• Implementation of screening requires careful consideration of benefits versus harms.

Purpose of the Study:

• To evaluate the evidence supporting routine screening for Adverse Childhood Experiences (ACEs).
• To identify gaps in the evidence base for ACEs screening.
• To propose alternative resource allocation strategies.

Main Methods:

• Literature review and critical analysis of existing evidence on ACEs screening.
• Examination of screening principles and their application to ACEs.
• Discussion of population-level versus individual-level data interpretation.

Main Results:

• There is a lack of randomized controlled trials demonstrating benefits of ACEs screening programs.
• Current calls for ACEs screening often overlook established evidence requirements.
• Translating population-level associations to individual-level benefits is not straightforward.

Conclusions:

• Directing resources to ACEs screening without proven benefits is problematic.
• Investment in high-quality prevention intervention trials is advocated.
• Prioritizing evidence-based treatments for existing conditions is recommended, irrespective of ACEs attribution.